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Imaging features of hepatocellular carcinoma compared to intrahepatic cholangiocarcinoma and combined tumor on MRI using liver imaging and data system (LI-RADS) version 2014

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Abstract

Purpose

To evaluate the prevalence of major and ancillary imaging features from liver imaging reporting and data systems (LI-RADS) version 2014 and their interreader agreement when comparing hepatocellular carcinoma (HCC) to intrahepatic cholangiocarcinoma (ICC) and combined tumor (cHCC-CC).

Methods

The Institutional Review Board approved this HIPAA-compliant retrospective study and waived the requirement for patients’ informed consent. Patients with resected HCC (n = 51), ICC (n = 40), and cHCC-CC (n = 11) and available pre-operative contrast-enhanced MRI were included from 2000 to 2015. Imaging features and final LI-RADS category were evaluated by four radiologists. Imaging features were compared by Fisher’s exact test and interreader agreements were assessed by κ statistics.

Results

None of the features were unique to either HCC or non-HCC. Imaging features that were significantly more common among HCC compared to ICC and cHCC-CC included washout (76%–78% vs. 10%–35%, p < 0.001), capsule (55%–71% vs. 16%–49%, p < 0.05), and intralesional fat (27%–52% vs. 2%–12%, p < 0.002). Features that were more common among ICC and cHCC-CC included peripheral arterial phase hyperenhancement (40%–64% vs. 10%–14%, p < 0.001) and progressive central enhancement (65%–82% vs. 14%–25%, p < 0.001). The interreader agreement was moderate for each of these imaging features (κ = 0.41–0.55). Moderate agreement was also achieved in the assignment of LR-M (κ = 0.53), with an overall sensitivity and specificity for non-HCC malignancy of 86.3% and 78.4%, respectively.

Conclusion

HCC and non-HCC show significant differences in the prevalence of imaging features defined by LI-RADS, and are identified by radiologists with moderate interreader agreement. Using LI-RADS, radiologists also achieved moderate interreader agreement in the assignment of the LR-M category.

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Authors and Affiliations

  1. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    Natally Horvat, Ines Nikolovski, Niamh Long, Scott Gerst, Lorenzo Mannelli & Richard Kinh Gian Do

  2. Department of Radiology, Hospital Sírio-Libanês, Sao Paulo, Brazil

    Natally Horvat

  3. Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Jian Zheng, Linda Ma Pak, Amber Simpson & William R. Jarnagin

  4. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Cencer, New York, NY, USA

    Junting Zheng & Marinela Capanu

Authors
  1. Natally Horvat
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  2. Ines Nikolovski
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  3. Niamh Long
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  4. Scott Gerst
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  5. Jian Zheng
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  6. Linda Ma Pak
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  7. Amber Simpson
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  8. Junting Zheng
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  9. Marinela Capanu
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  10. William R. Jarnagin
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  11. Lorenzo Mannelli
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  12. Richard Kinh Gian Do
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Contributions

Study concepts and study design, N. H., R. K. G. D.; literature search, N. H., R. K. G. D.; image review, I. N., N. L., S. G., L. M.; clinical information review, J. Z., L. M. P., A. S., W. R. J., N. H.; statistical analysis, J. Z., M. C.; manuscript drafting and edition, N. H., R. K. G. D., I. N., J. Z., J. Z.; approval of final version of submitted manuscript, all authors.

Corresponding author

Correspondence to Richard Kinh Gian Do.

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Funding

This work was supported in part by NIH/NCI P30 CA008748 Cancer Center Support Grant.

Conflict of interest

The authors have declared that no competing interests exist.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Horvat, N., Nikolovski, I., Long, N. et al. Imaging features of hepatocellular carcinoma compared to intrahepatic cholangiocarcinoma and combined tumor on MRI using liver imaging and data system (LI-RADS) version 2014. Abdom Radiol 43, 169–178 (2018). https://doi.org/10.1007/s00261-017-1261-x

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  • DOI: https://doi.org/10.1007/s00261-017-1261-x

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